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Peer-reviewed veterinary case report

Surgical correction of nephrosplenic entrapment of the large colon in 3 horses via standing left flank laparotomy.

Journal:
Veterinary surgery : VS
Year:
2015
Authors:
Krueger, Clarisa R & Klohnen, Andreas
Affiliation:
Elgin Veterinary Hospital · United States
Species:
horse

Plain-English summary

In this study, three horses were treated for a condition called nephrosplenic entrapment, where the large intestine gets trapped near the spleen, causing colic (abdominal pain). The horses were diagnosed through a physical exam and ultrasound, and their symptoms did not improve with medication or exercise. The veterinarians performed a surgery called a standing left flank laparotomy, which allows the procedure to be done while the horse is awake and sedated. All three horses had successful surgeries, with one experiencing a fever afterward, but they were able to go home within two to three days and returned to their normal activities within a month. Overall, this surgical method proved to be effective and helped the horses recover quickly.

Abstract

OBJECTIVE: To describe a technique for surgical correction of nephrosplenic entrapment via standing left flank laparotomy. STUDY DESIGN: Case series. ANIMALS: Horses (n = 3). METHODS: Nephrosplenic entrapment was diagnosed by abdominal palpation per rectum in all 3 horses and confirmed by transabdominal ultrasonography in 2 horses. Duration of colic was variable and failed to resolve after medical management, phenylephrine administration, and jogging. With sedation and local analgesia, standing left flank laparotomy using a modified grid approach was performed to correct the entrapment. Follow-up information was obtained by telephone communication with trainers or owners. RESULTS: Nephrosplenic entrapment was successfully corrected in all horses; postoperative fever occurred in 1 horse. Horses were discharged after 48-72 hours and returned to previous use within 30 days. CONCLUSION: Standing flank laparotomy is an alternative for horses with nephrosplenic entrapment unresponsive to medical therapy when general anesthesia and exploratory celiotomy are not an option because of financial constraints or a high anesthetic risk. This approach leads to a favorable outcome, reduces hospital stay and associated costs and leads to a rapid return to function.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/25307802/